Survey Items:Survey instrument item number for children 0-5 years: C18; for children 6-11 years: C16; for children 12-17 years: C17 Variable name in public use data file: K4Q22_R

Denominator:Children age 3-17 years, reported by their parents to have been diagnosed by a health care provider with a mental/behavioral condition (depression, anxiety problems, or behavioral or conduct problems)

Numerator:Children, ages 3 through 17, reported by their parents to have been diagnosed by a health care provider with a mental/behavioral condition (depression, anxiety problems, or behavioral or conduct problems) who received treatment or counseling

Revisions and Changes:In 2017, this measure did not change from the 2016 NSCH.
Due to previous changes in the administration and sampling for the NSCH, results from surveys prior to 2016 are not directly comparable and should not be used to conduct trend analyses. The denominator of the measure is changed in 2016. In the 2011/12 NSCH, this question was asked among children 2-17 years, and the denominator of this measure was children age 3-17 who were found to have an emotional, developmental, or behavioral problem from the CSHCN Screener (qualified on the CSHCN Screener question #5). In the 2016 NSCH, the denominator of this measure changed to children age 3-17 years who currently have anxiety, depression, or a behavioral/conduct disorder. The 2016 NSCH question was asked among all children 0-17 years old, and the “No” response previously used in the 2011/12 NSCH was broken down in 2 responses in the 2016 NSCH: “No, but needed to see a mental health professional” and “No, did not need to see a mental health professional”. For more information on content changes, click here .

Additional Notes:The denominator of this measure is children age 3-17 who currently have one of the three diagnosed conditions: depression, anxiety problems, or behavioral or conduct problems. These children are grouped according to whether or not they received treatment from a mental health professional during the past 12 months (K4Q22_R). Two response options to K4Q22_R “Did not receive mental health care, but needed it”, and “Did not receive mental health care, but did not need it” were combined to identify children who did not receive mental health care.

Treatment of Unknown Values:Missing values due to non-response or a “don’t know” response are not included in the denominator when calculating prevalence estimates and weighted population counts displayed in the data query results table. In the majority of cases, the proportion of missing values is less than 2%. Exceptions are noted in the form of a Data Alert at the bottom of a results table. The exclusion of these values does not change the prevalence estimates (%) and only marginally affects the weighted population counts (Pop. Est.). If missing cases are handled in any other way, details can be found in the "Additional notes" section above.

History and Development:Overview of the Title V Block Grant
The Title V Maternal and Child Health (MCH) Services Block Grant Program operates as a federal-state partnership in 59 states and jurisdictions to improve the health and well-being of MCH populations through the development of public health systems of care which are family-centered, community-based and culturally appropriate. To improve accountability and to more clearly demonstrate the impact of the Title V Block Grant Program, an updated national performance measure framework was introduced in 2015. This three-tiered framework includes National Outcome Measures (NOMs), National Performance Measures (NPM) and state-initiated Evidence-Based or –Informed Strategy Measures (ESMs). Updates to the Application/Annual Report Guidance released by HRSA in December 2017 retained the performance measure framework, but allowed greater flexibility for states in selecting national and state performance measures that align with their individual MCH priority needs. More information about the block grant can be obtained at the MCHB website.

About NSCH
The Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB) funds and directs the National Survey of Children’s Health (NSCH), and develops survey content in collaboration with the U.S. Census Bureau and a Technical Expert Panel. The Technical Expert Panel consists of experts in survey methodology and children’s health, federal and state stakeholders, clinicians and researchers. The U.S. Census Bureau conducts the survey, oversees the sampling, and produces a final data set of survey results. Respondents’ cognitive understanding of the survey questions was assessed during the pretest phase of the survey redesign and reassessed after the 2016 survey; subsequent revisions were made. Previously validated questions and scales are used when available. The manuscript “The Design and Implementation of the 2016 National Survey of Children’s Health”, provides detailed information about the redesign of the NSCH, administration of the first redesigned survey (2016), and the sampling and administration changes for the 2017 NSCH.
Prior to 2016, the NSCH and the National Survey of Children with Special Health Care Needs were each conducted three times as interviewer-assisted telephone surveys using random digit dial sampling. In 2016, the two surveys were combined into a single annual self-administered questionnaire. Due to decline in the number of households with landline telephones, the NSCH now utilizes an address-based sampling method to select participating households, thus all invitations are sent by mail. Participants may choose to complete the survey either online using a secure website or a mailed paper version of the survey.
All final data components are verified by the Census Bureau, HRSA/MCHB and CAHMI/DRC staff prior to public release. More information about the survey can be found in the “About the National Survey of Children’s Health” section of this website and HRSA’s MCHB website.

This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant number U59MC27866,National Maternal and Child Health Data Resource Initiative, $4.5M. This information or content and conclusions are those of the author and should not be construed as the official position of or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.